经肛门显微手术治疗直肠肿瘤的效果及对血清炎症因子的影响

The Effect of Transanal Microsurgery in the Treatment of Rectal Tumors and Its Influence on Serum Inflammatory Factors

目的探讨经肛门显微手术治疗直肠肿瘤的效果及对血清炎症因子的影响。方法94例研究对象均为方便选取的2018年6月—2020年5月该院收治的直肠肿瘤患者,以随机数字表法划分为两组。研究组47例接受经肛门显微手术,对照组47例接受传统直肠癌根治切除术(Miles手术)。比较两组直肠肿瘤患者术中与术后恢复情况、肛门括约肌宽度与厚度、血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)]水平,以及术后并发症情况。结果在两组术中情况手术时间与术中失血量比较中,研究组(92.5±15.5)min、(53.5±12.2)mL较对照组(155.3±35.0)min、(185.5±22.3)mL更低,差异有统计学意义(t=11.247、35.601,P<0.001),在术后情况肛门排气时间与住院时间比较中,研究组(3.5±0.3)d、(11.5±2.4)d较对照组(5.1±0.5)d、(16.7±3.0)d更低,差异有统计学意义(t=18.812、9.279,P<0.01)。术后研究组肛门括约肌宽度(1.8±0.2)mm、厚度(30.4±5.2)mm较对照组(1.5±0.2)mm、(24.5±5.0)mm更高,差异有统计学意义(t=7.272、5.607,P<0.01)。术后研究组TNF-α(19.5±2.4)ng/L、IL-6(159.3±13.0)pg/L较对照组(27.6±2.0)ng/L、(192.5±12.8)pg/L更低,差异有统计学意义(t=17.775、12.476,P<0.001),IL-2(34.5±6.2)pg/L较对照组(25.8±5.0)pg/L更高,差异有统计学意义(t=7.488,P<0.01)。在两组术后并发症发生率比较中,研究组(6.38%)较对照组(21.28%)更低,差异有统计学意义(χ^(2)=4.374,P<0.05)。结论经肛门显微手术在直肠肿瘤患者中具有显著的应用效果与安全性,且抑制了血清炎症因子水平。

Objective To investigate the effect of transanal microsurgery in the treatment of rectal tumors and its influence on serum inflammatory factors.Methods Convenient select the 94 study subjects were all rectal tumor patients admitted to the hospital from June 2018 to May 2020,and were divided into two groups by a random number table method.47 cases in the study group underwent transanal microsurgery,and 47 cases in the control group underwent conventional radical resection of rectal cancer(Miles operation).To compare the recovery of rectal tumor patients during and after operation,the width and thickness of anal sphincter,and serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-6(IL-6)]level,and postoperative complications.Results In the comparison of intraoperative operation time and intraoperative blood loss between the two groups,the study group(92.5±15.5)min and(53.5±12.2)mL were more than the control group(155.3±35.0)min and(185.5±22.3)mL,the differences was statistically significant(t=11.247,35.601,P<0.01).In the comparison of the postoperative anal exhaust time and hospitalization time,the study group(3.5±0.3)d and(11.5±2.4)d were compared with the control group(5.1±0.5)d,(16.7±3.0)d was lower,the differences was statistically significant(t=18.812,9.279,P<0.01).The postoperative anal sphincter width(1.8±0.2)mm and thickness(30.4±5.2)mm in the study group were higher than those in the control group(1.5±0.2)mm and(24.5±5.0)mm,the difference was statistically significant(t=7.272,5.607,P<0.01).TNF-α(19.5±2.4)ng/L and IL-6(159.3±13.0)pg/L in the postoperative study group were lower than those in the control group(27.6±2.0)ng/L and(192.5±12.8)pg/L,the differences was statistically significant(t=17.775,12.476,P<0.01),IL-2(34.5±6.2)pg/L was higher than the control group(25.8±5.0)pg/L,the differences was statistically significant(t=7.488,P<0.01).In the comparison of the incidence of postoperative complications between the two groups,6.38%of the study group was lower than 21.28%of the control group,the differences was statistically significant(χ^(2)=4.374,P<0.05).Conclusion Transanal microsurgery has significant application effect and safety in patients with rectal tumors,and it inhibits the level of serum inflammatory factors.